Healthcare Provider Details

I. General information

NPI: 1861686487
Provider Name (Legal Business Name): ROSE OSUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 MARENGO ST HRA BUILDING 3RD FLOOR
LOS ANGELES CA
90033-1036
US

IV. Provider business mailing address

1640 MARENGO ST HRA BUILDING 3RD FLOOR
LOS ANGELES CA
90033-1036
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-2200
  • Fax:
Mailing address:
  • Phone: 323-226-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number252343
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: